Contract analysis
Clause-by-clause risk read on any document of the firm. Pick a contract, or open any document from a matter.
Contract analysis / board-presentation-interim-findings.pptx
board-presentation-interim-findings.pptx
High · 1
Medium · 1
Standard · 3
1. Engagement Overview and Scope Recap
1. Engagement Overview and Scope Recap
2. Self-Assessment Methodology
2. Self-Assessment Methodology
3. Arrangement Inventory: Risk Tier Summary (40 Arrangements)
3. Arrangement Inventory: Risk Tier Summary (40 Arrangements)
4. High-Risk Arrangement Deep Dives: Meridian Diagnostics, Pinnacle Laboratory Services, M
4. High-Risk Arrangement Deep Dives: Meridian Diagnostics, Pinnacle Laboratory Services, Medical Director Compensation, Lakeview Legacy Arrangements, ConnectiCare MSA
5. Value-Based Arrangement Review — Covenant Health Plans
5. Value-Based Arrangement Review — Covenant Health Plans
6. State Law Overlay — Massachusetts and Connecticut
6. State Law Overlay — Massachusetts and Connecticut
7. Preliminary Remediation Recommendations
7. Preliminary Remediation Recommendations
8. Remaining Work Streams and Timeline
8. Remaining Work Streams and Timeline
9. Discussion and Questions
Medium
⚑ Liability cap to check against exposure
9. Discussion and Questions [slide 3] Engagement Overview and Scope Recap Engagement authorized by Board Resolution No. 2023-01-004 (January 24, 2023); opened January 30, 2023; estimated completion mid-2023 Triggered by Lakeview Medical Associates acquisition (August 15, 2022, $11.4M asset purchase) and Grayson Whitaker gap assessment report (GW-AHT-2022-Final, December 12, 2022) Grayson Whitaker identified 17 high-r
1. Meridian Diagnostics: Restructure per-scan fee to fixed monthly rental at FMV; draft ag
Standard
⚑ Commercial term
1. Meridian Diagnostics: Restructure per-scan fee to fixed monthly rental at FMV; draft agreement shared with Meridian's counsel (Linden & Pryor / Thomas Beckett)
2. Pinnacle Laboratory: Convert no-cost lab interface to FMV license; restructure CME spon
2. Pinnacle Laboratory: Convert no-cost lab interface to FMV license; restructure CME sponsorship; require CEO conflict-of-interest disclosure re: Dr. Karen Ellsworth's 4.2% equity interest
3. Medical Director Agreements (38): Restructure compensation to FMV using Northbridge opi
3. Medical Director Agreements (38): Restructure compensation to FMV using Northbridge opinions; increase documented hours; standardize duty descriptions; deploy revised template
4. Lakeview Legacy (14 employment + 3 MD + 2 leases): Replace with revised AHT templates;
4. Lakeview Legacy (14 employment + 3 MD + 2 leases): Replace with revised AHT templates; obtain Northbridge FMV opinions; cure holdover issues
5. ConnectiCare MSAs (9 practices): Restructure fee formula from percentage to fixed or bl
Standard
⚑ Commercial term
5. ConnectiCare MSAs (9 practices): Restructure fee formula from percentage to fixed or blended model; add referral tracking and indirect compensation safeguards
6. Policy Overhaul: Redraft 7 policy documents — compliance manual, physician compensation
Standard
⚑ Commercial term
6. Policy Overhaul: Redraft 7 policy documents — compliance manual, physician compensation, referral, vendor, gifts/meals/entertainment, FMV procedures, non-monetary remuneration tracking
7. Contract Templates: Redraft 6 templates — physician employment, IC/medical director, of
7. Contract Templates: Redraft 6 templates — physician employment, IC/medical director, office lease, equipment lease, MSA, vendor agreements
8. Voluntary Disclosure: Evaluate CMS SRDP or OIG SDP filing once all analyses complete
High
⚑ Penalty / liquidated damages
8. Voluntary Disclosure: Evaluate CMS SRDP or OIG SDP filing once all analyses complete [slide 15] Remaining Work Streams and Timeline April–May 2023: Receive and integrate Northbridge FMV opinions (52 physician arrangements, 2 office leases, Meridian facility fee) April–May 2023: Finalize all policy and procedure redrafts (7 policy documents) and contract templates (6 templates) May 2023: Transmit Meridian restructu